Study On The Risk Factors Of Ischemic Stroke And Its Relationship With Serum Uric Acid Levels In Young Adults

Objectives:To explore the youth related risk factors of ischemic stroke,to research the relationship between the change of blood uric acid levels and incidence of young ischemic stroke as well as the degree of nerve function defect,provided the targets for clinical reasonable and effective prevention.Subjects and methods:Subjects: The choice of cases: From January 1,2014 to May 1,2016 in Affiliated Hospital of Chengde Medical College Department of internal medicine and confirmed by head CT or MRI confirmed the diagnosis of acute ischemic stroke patients and age 18 to 45 as the research object,included in the studysample size of 201 patients.The choice of the control group: selected physical examinationers from Affiliated Hospital of Chengde Medical College Department of Physical examination center of no stroke,age 18 to 45 years old the youth as a control,ncluded in the studysample size of 202 patients.Methods: Using the research methods of Cases-controlled trial,collected information of the research object,used the unified survey form,collected the general information(name,age,sex,admission number),previous history(hypertension,diabetes,atrial fibrillation,coronary heart disease,smoke,drink and so on),present illness(clinical feature,physical examination,laboratory examination and imageological examination);nerve function defect severity classification standard was on the basis on the research object into hospital day 1,were scored by National Institute of Health stroke scale,(NIHSS),accorded to the NIHSS score,the research object were divided into three groups: mild group(0-7),moderate group(8-13),heavy group(>=14);and Complete the data entry and analysis.Analysis using SPSS19.0 statistical software.General comparison between the two groups: The measurement data was demonstrated by mean and standard deviation(x ±s),the two groups were compared using Independent sample T test,Count data was demonstrated by the number of case and rate(n %),the two groups were compared by the ?2 test,using Single factor unconditioned Logistics regression analysis to explore the youth related risk factors of ischemic stroke,correlation analysis using Pearson.The research object were divided into three groups: mild group(0-7),moderate group(8-13),heavy group(>=14),Single factor analysis of variance was used to compare different nerve function defect degree of the youth the difference of blood uric acid levels in patients with stroke.The data processing analysis using SPSS19.0 statistical software,When P<0.05,the difference was statistically significant.Result:1 The clinical data of young ischemic stroke patients and healthy persons were compared,there were significant differences between the two groups in gender,smoking,drinking,history of hypertension,history of diabetes and coronary heart disease(P<0.05).There were significant differences in serum uric acid,high density lipoprotein,triglyceride,creatinine and homocysteine(P<0.05).There was no significant difference in age,atrial fibrillation and LDL.2 As a dependent variable in young patients with ischemic stroke,With gender,age,hypertension,diabetes,coronary heart disease,atrial fibrillation,smoking,drinking,uric acid(UA),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),triglycerides(TC),creatinine(CRE),homocysteine(HCY)and other factors do single unconditioned logistics factors regression analysis,Results suggested the male,age,hypertension,diabetes,coronary heart disease,smoking,drinking,uric acid,homocysteine,triglycerides,creatinine were the risk factors for the youth ischemic stroke(P<0.05),the EXP(95CI%)were 0.219(0.141 ~ 0.340),1.035(1.002 ~ 1.069),30.919(15.409 ~ 62.043),4.442(1.979 ~ 9.881),4.587(1.287 ~1 6.351),6.359(3.931 ~ 10.287),4.960(3.01 ~ 8.161),1.006(1.006 ~ 1.009),1.290(1.226 ~ 1.359),5.767(4.015 ~ 8.282),1.045(1.031 ~1.059);female,high-density,lipoprotein cholesterol(HDL-C)were the protective factors for the youth ischemic stroke,the EXP(95CI%)were 0.219(0.141 ~ 0.340),0.029(0.014 ~ 0.063).3 Single factor analysis of variance was used to compare the relationship between serum uric acid level and the degree of neurological impairment in young patients with ischemic stroke,results suggested: In different degree of nerve function defect,the level of uric acid in mild group were lower than that in moderate and heavy group,the difference was statistically significant(P<0.05),the level of uric acid in moderate group was lower than that in heavy group,differences between the two groups have no statistical significance(P>0.05).The results showed that the higher the level of serum uric acid,the higher the NIHSS score on admission,the more serious of nerve function defect severity.4 The level of serum uric acid with ischemic stroke in youth risk factors of hypertension,diabetes,coronary heart disease,atrial fibrillation,smoking,drinking,triglyceride,high density lipoprotein,creatinine,homocysteine and the NIHSS score adoption Pearson correlation analysis,the level of serum uric acid was significantly correlated with hypertension(r=0.213,P=0.002),creatinine(r=0.392,P<0.001),NIHSS(r=0.241,P=0.001).However,there was no significant correlation between diabetes mellitus,coronary heart disease,atrial fibrillation,smoking,drinking,triglyceride,high density lipoprotein,low density lipoprotein and homocysteine.Conclusion:1 The risk factors of ischemic stroke in young people were gender,age,hypertension,diabetes mellitus,coronary heart disease,smoking,drinking,uric acid,triglyceride,low density lipoprotein,creatinine and homocysteine;2 The level of serum uric acid may increase the degree of neurological impairment in young ischemic stroke patients;3 Changes in serum uric acid levels were positively correlated with the level of hypertension,the level of serum CRE and the degree of neurological deficit.